TMSS Medical College Journal

Background: Antenatal care refers to the care given to women during pregnancy and child birth to achieve at the end of pregnancy a healthy mother and a healthy child. It is one of the important factor to reduce maternal morbidity and ‘mortality. Objective: To identify the determinants of antenatal care (ANC) attendance and to describe the maternal and perinatal outcome. Materials & Methods: This study was carried out among 400 expectant mothers having last children two years or less during the period from January, 2015 to December, 2015 who attended the ANC care unit of Rafatullah Community Hospital (RCH) attached to TMSS medical college, Bogra. Results: Reproductive history of women reveals that, age at marriage was between 20 to 24 years. Among the respondents, 240 (60%) had taken WHO recommended 4 or more antenatal visits and 160 (40%) 1-3 visits during the pregnancy period. All the mothers had taken TT immunization according to EPI schedule. 260 (65%) pregnant women were anaemic and 140 (35%) healthy. The respondents had developed PIH (Pregnancy Induced Hypertension) in 40 (10%), eclampsia in 8 (2%) & APH in 20 (5%) cases respectively. Retained placenta occured in 20 (5%) eases. Of the respondents 340 (85%) had delivered normal and 60(15%) low birth weight babies. 260 (45%) normal deliveries and 140 (35%) cesarean section deliveries were done both in multigravida and primigravida cases. Neonatal death occurred in 8 (2%) cases. Conclusion: Although the attendance of pregnant women to ANC is encouraging, the safe motherhood strategies need to be targeted to rural area in order to increase access to ANC and delivery care, preparing community health workers to promote ANC, improving the quality of ANC offered by doctors and nurses at primary health care level and availability of medical facilities to be strengthen.

Quality antenatal care is the fundamental right of expectant mothers to safe guard their health and that of their infants. Antenatal care allows management of pregnancy, detection and treatment of complications and promotion of better maternal and child health!. The World Health Organization (WHO) defines women of reproductive age as those who are aged 15-49 years. They constitute more than one-fifth of the worlds population and are repeatedly exposed to the risk of pregnancy and childbearing. According 10 WHO recommendation, every pregnant woman should receive at least four ANC visits during pregnancy’. The use of ANC in developing countries is low compared to developed countries (97%). The Bangladesh Demographic and Health survey (BDHS) 2011, showed that 55% of women with a birth in the three years preceding, the survey received ANC at least once from any provider’. The expectant mothers had received ANC from medically - trained provider, such as doctors, nurses, midwives and family welfare visitors. In developing countries, women often have to encounter serious health risks during pregnancy such as anaemia, oedema, eclampsia for themselves or sepsis and pneumonia, birth ‘asphyxia, tetanus, congenital anomalies and low birth weight for their children. These problems are prevalent due to socio-economic condition, low maternal education and lack of ANC Knowledge and practice and inaccessibility to health facilities. The wide disparity in the matemal health care indicators might explain the wide difference in the Matemal Mortality Rate (MMR) between the developed and the developing countries. Data from 2014 BDHS shows that in our country, Infant Mortality Rate (IMR) is 38 deaths per 1000 live birth and under-S Mortality 46 per 1000 live birth ‘while in USA IMR is 7 and under-S Mortality Rate is 8 per 1000 live birth. The HPNSDP (MOHFW. 2011) aims to decrease IMR to 30 and under-5 mortality to 38 per 1000 live birth by 2016 respectively. Bangladesh has reduced Maternal Mortality Rate (MMR: the number of materal deaths per 100.000 live birth) from 322 in 2001 to 170in 2014 while in USA MMR is 21. Bangladesh is also committed to reach the Sustainable Development Goal (SDG) pertaining to reduce MMR t0 70 per 100.000 live birth by 2030.7 Of the 210 million women who become pregnant each year, 30 million or about 15% develop complications". Available information indicates hat, about $200 women in Bangladesh dic due to pregnancy and birth-related complications**”. ‘These complications can be managed and treated if timely and appropriate antenatal care is sought from facilities with necessary skilled care providers.